NHS consultants crisis calls for a public remedy

Julie Currie

Would you go to the supermarket, fill up your trolley and expect to walk out with the contents for free?

Sounds implausible, yes? Well that’s how people want the NHS to operate – and it can’t continue.

Simon Barker...the Aberdeen-based paediatric orthopaedic surgeon who was elected chairman of the BMA's Scottish Consultants Committee in August.

So said the newly-appointed chairman of the British Medical Association’s Scottish Consultants Committee.

And Simon Barker believes the public must play a pivotal role in shaping the future direction of the NHS in Scotland – to ensure the service continues.

Simon spoke out as the latest consultants recruitment figures showed a “worrying” level of vacancies.

ISD Scotland statistics issued this month reveal that the consultancy vacancy rate is running at 6.9 per cent, up from 6.4 per cent last year.

Almost half (47 per cent) of the posts have been vacant for six months or more.

While Scottish health secretary Shona Robison said the NHS workforce was at an all-time high, Simon said it wasn’t enough to create extra posts – they needed to be filled too.

“The fact that almost half of all medical consultant vacancies have been vacant more than six months highlights the difficulties some specialties are experiencing in recruiting and retaining doctors,” he said.

“Despite advertising, these gaps are not being filled and this is causing unrelenting pressure on those doctors working in the health service.

“The Scottish Government must now take action to value the consultants we do have, find a way to attract more doctors to work in Scotland and fill vacant posts.”

But Simon believes far more needs to be done than just number crunching.

He wants the Scottish Government and employers to start valuing NHS staff.

Explaining why, he said: “We are being asked to do more with less, staff feel completely undervalued and are leaving before they should due to worsening pension deals and a management-driven culture.

“It’s a perfect storm with vacancies impacting on the doctors who do stay – as they also have to provide more weekend cover.

“There’s a lot of complex factors and while politicians are sympathetic, they feel there is little that can be done in these cash-strained times.

“But some of the things that make people feel valued are not solved with golden soverigns from the heavens. It would help if the government and employers focused on how to value their staff, rather than view them as a burden.”

Simon is the first to admit there is no quick fix to solve all the ills of the NHS.

However, he believes the government needs to start talking to the public to find solutions.

He explained: “Politicians go into their bunkers and say we are spending more money than ever before on the NHS.

“But they’re not spending enough to deliver everything and are spending less than our European neighbours.

“Politicians are scared to say we can’t provide the whole package as it would be political suicide for them.

“But we need to start being honest with people and admitting that, while they have a right to health care, we need to make some tough choices.

“The NHS needs a lot more money than we are currently prepared to put in so we need to decide if we want everything or if some things are less essential.

“At the moment, it’s a bit like pushing your trolley round the supermarket, filling it up and then not being prepared to pay for it.”

Simon appreciates this is not what people want to hear but feels the public deserves to have a say.

He said: “The public in Scotland needs to decide what they want from the health service.

“The money has to come from somewhere and unless the government engages with them on this subject, we will end up with a worse service than we now have.

“I think we need to take it out to town halls and ask people what kind of health service they want and how they are prepared to pay for it so that future generations have a health service they will be proud of.”

Simon advocates speaking to people at town hall meetings rather than in formal questionnaires – as he believes it is the only way to truly gauge public opinion.

“We need to be more engaging,” he said. “It’s not everyone who will sit and fill out a form on the internet.

“You’ll reach a certain amount of people who enjoy filling out forms but you won’t engage with everyone so consultation becomes a whisper rather than a roar.”

As for the reason why there are currently around 300 consultant vacancies in Scotland – half of which have not been filled for more than six months – Simon said the issues were complex.

“There’s not just one reason so there is no quick fix – I appreciate that,” he added.

“But part of the problem is that consultants roles have not been a very attractive proposition in recent years.

“They don’t seem to place a great deal of value in what we do – it’s the same with staff throughout the NHS.

“We all feel the pressure of work and there’s less job satisfaction now.

“We work 10 sessions a week, two and a half sessions of which we used to use to do research and train the next generation of doctors. But 12 years ago that changed to a nine to one ratio.

“That seems to be, on the face of it, a great deal for patients and health boards.

“And, in the short term, it is a quick fix to see more patients. However, taking away the behind the scenes work means the NHS will suffer in the long term.

“It’s a huge demotivator and a lot of junior doctors in England are put off coming to Scotland due to that ratio.”

Health Minister Shona Robison: NHS staffing levels are at a record high

Health Minister Shona Robison was keen to stress how well-staffed the NHS currently is.

Responding to the criticism, she said: “Under this Government, NHS staff numbers have risen to record highs – with more consultants, nurses and midwives now delivering care for the people of Scotland.

“There are now 11,500 more staff working in our NHS, with nearly 1000 of these recruited in the last year. In the last ten years we’ve also seen a 45.8 per cent increase in medical and dental consultants with vacancy rates at the same level, despite this huge increase in numbers.

“These extra staff will ensure people all across Scotland get the high-quality NHS services that they rightly expect.

“We are also committed to preparing our NHS workforce for the future by increasing student nursing and midwifery intakes for the last four years.

“That’s helped to see almost 10,000 nurses and midwives in training in 2015.

“With demand on our NHS rising we’re committed to both record investment in our health service and ensuring the necessary reforms to deliver the right staff, with the right skills, in the right place, long into the future.

“We’ll soon be setting out our National Health and Social Care Workforce Plan for discussion, working with individuals and organisations within our NHS and social care services to ensure we have the right skills mix for the future.”

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